Do you know what is really causing your IBS?

What is IBS?

Irritable Bowel Syndrome (IBS) is the most common functional gastrointestinal disorder worldwide. It is characterized by collection of symptoms such as bloating, flatulence, nausea, constipation, diarrhea, stomach pain or discomfort, alternating constipation and diarrhea.

Symptoms can range from mildly annoying to completely embarrassing, and difficult to deal with.

IBS is normally diagnosed after your doctor has ruled out inflammatory bowel disease (IBD), GERD, diverticulitis, and other problems that can affect your GI tract. To suppress the symptoms of IBS, your doctor might prescribe medication such as pain relievers or medication to alter gut motility.

But do you still find hard to relax when you travel or leave home, for fear that you won’t find a bathroom? Do you still worry that your next meal will bring on cramps and discomfort that could have negative impact on your ability to engage at work or social life?

A diagnosis of (IBS) does not always help, and you might like to find a long-term solution to gain control over your health and life.

So what causes Irritable Bowel Syndrome? There is no single cause, and it depends on the individual. Because IBS is a complex collection of symptoms, there can be a combination of possible causes. To get long lasting relief, it is vital to investigate and eliminate these contributing factors:

1) Stress and anxiety. Studies have demonstrated the link between higher stress levels and increased IBS symptom (1). This is because our brain and gut have a connection (gut-brain axis). When we are anxious or stressed, our body’s stress response can result in increased or reduced motility of the colon resulting diarrhea or constipation. This is seen in many people suffering with IBS, as their symptoms worsen when they are stressed.

2) Hormonal Imbalances. Data from studies demonstrate that sex hormones play an important role in the regulating mechanisms of the brain-gut-microbiota axis which are involved in the pathophysiology of IBS (2). Alterations in ovarian hormones have an effect on IBS symptoms. This could explain worsening of IBS symptoms around the time of menses and early menopause in woman (3).

3) Small intestine bacterial overgrowth (SIBO). SIBO is characterized by an abnormal overgrowth of bacteria in the small intestine. The symptoms of IBS are similar to SIBO and include flatulence, bloating and diarrhea. SIBO is found in 4-78% of patients suffering with IBS (4). This range could vary due to poor diagnostic techniques and the lack of standard method of testing for SIBO. A study demonstrated improvement in IBS symptoms in nearly half of the patients treated for SIBO (5).

4) Low stomach acid. One study demonstrated that reduced stomach acid secretion is associated with increased bacterial overgrowth in duodenum (small intestine) and increased intestinal transit (6), which can be associated with SIBO.

5) Lack of digestive enzymes. Our pancreas produces digestive enzymes that are essential for the proper digestion and absorption of ingested food. Any disruption of this process can result malabsorption and diarrhea. One study demonstrated that 6% of patients suffering with diarrhea predominant IBS had a reduced secretion of pancreatic enzymes. Supplements of pancreatic enzymes in these patients reduced diarrhea and abdominal pain (7).

6) Gut infections Parasites/ bacteria. Our gut is protected from pathogenic invaders because of acid production in the stomach. Due to the multiple factors – such as chronic stress, acid-suppressing drugs, nutrient deficiencies – this defense system can be weakened. A number of bacterial, viral and parasitic pathogens are associated with the development of IBS. Studies have shown that intestinal parasites, such as Giardia lamblia, Blastocystis hominis and Dientamoeba fragilis, often remain undiagnosed but may be a common cause of IBS (8). In addition, GI infection caused by Campylobacter bacteria are risk factors for the development of IBS (9).

7) Food intolerances/sensitivities. Food intolerance is described by inability to digest specific foods – for example, lactose in the milk, sucrose- naturally occurring sugar in fruit. Intolerance occurs due to lack of the enzymes, rather immune response. Dietary intolerances to certain foods can lead to IBS-like symptoms.

Food sensitivities cause a delayed immune responses and increased IgG. It may take up to 72 hours for symptoms to appear. Food hypersensitivity can irritate GI and cause IBS symptoms, such as flatulence, bloating, abdominal cramps, changes in stool frequency and consistency. Some of the most common food triggers are gluten, dairy, peanuts, corn, soy, eggs and citrus fruits.

8) Dysbiosis/yeast overgrowth. The human intestinal microflora is a complex community that influences physiology, metabolism, nutrition, and immune function. Dysbiosis is characterized by deviation from normal microflora composition. Studies have demonstrated that a large number of patients suffering with IBS have quantitative and qualitative alterations in fecal and intestinal microflora (10).

Yeast overgrowth is commonly known as candidosis. It occurs when the balance of gut microflora is disturbed and candida takes over. There is increasing evidence that Candida can cause IBS-like symptoms, such as bloating, gas, alteration in intestinal habits via its released toxins (11).

What is better approach to IBS?

People suffering with IBS might have one or several factors that can trigger, influence, or exacerbate IBS. It is important to identify specific factors. Conventional medicine practitioners merely focus on managing the symptoms of IBS. However, leaving the underlying cause untreated can result in even more serious health issues. A Functional Medicine practitioner can help you to identify the cause of your IBS through an in-depth consultation and non-invasive testing. Ruling out the cause can help you to regain your digestive health and become symptoms free.